Status 3 September 2008 Hurricane Gustav

Status 3 September 2008 Hurricane Gustav Primary Care Manager (PCM) Blanket Referral Waiver The TRICARE Regional Office-South (TRO-South) began following the progress of Hurricane Gustav on 25 Aug 08 while it was still a tropical storm. TRO-South partnered with Humana Military Health Systems (HMHS), TRICARE Management Activity (TMA), and the Military Treatment Facilities in the South Region to prepare for the Hurricane to hit the Louisana (LA) coast. TRO-South and HMHS met several times with TMA’s Emergency Support Working Group (ESWG) to discuss disaster preparation prior to the Hurricane hitting the LA shore. Approximately 503,000 TRICARE beneficiaries reside in the Texas, Louisiana, Arkansas, Mississippi, Alabama, and Florida area that were directly or indirectly impacted by Hurricane Gustav. The resultant disruption may prevent access to their Primary Care Manager (PCM) by a large number of Prime beneficiaries. These beneficiaries often require urgent medical care on the same day of their request. Electronic medical claims often process within a day or two after the date of service resulting in point of service (POS) charges if a waiver of PCM referral requirements was not established. Although the Managed Care Support Contractor (MCSC) is required to have a Health Care Finder (HCF) service for referrals, it might be impractical for beneficiaries to contact the MCSC because of landline and cell phone outages. TRO-South in coordination with TMA’s ESWG and HMHS submitted a consolidated request to waiver the primary care manager referral requirement in the area impacted by the Hurricane. The approved waiver was signed by Dr. Cascell’s on 2 Sept and covers the period 29 Aug 08 through 12 Sep 08 for the affected area. The waiver covers prime beneficiaries in the identified area on the chart below. Please see the map and chart for the area designated for the PCM waiver. As recovery operations occur and the extent of the damage to local infrastructures is further defined, extension of a PCM waiver past the 12 Sep in the hardest hit areas will be reviewed by TRO-South. Pharmacy Waiver In addition, TRICARE Management Activity (TMA) worked with Express Scripts to have them provide an automatic override to early prescriptions so that the beneficiaries in the impacted area can obtain early refills of medications prior to or after evacuating starting 29 Aug 08 and will continue for 4 to 6 weeks. Status of Facilities The following MTFs Operations as well as the TSCs that support these MTFs have been affected: Keesler AFB MS – Closed 2 September, Re-evaluate opening 3 Sept COB CG Clinic Galveston – Limited Operations 2 Sept, Reopen Full Operations 3 Sept Fort Polk LA – Closed 2,3, Reopen Full Operations 4 Sept. NBHC East Bank, NBHC West Bank, NBHC Belle Chasse, CG ISC Clinic New Orleans - Local Authorities to Determine, Not Expected Before 4 Sept Barksdale AFB, LA – Closed 2, 3 Sept, Expected Reopen 4 Sept. Baynes-Jones Army Community Hospital, Ft. Polk, LA – Closed 2,3 Sept, Expected Reopen 4 Sept. Alexandria Town Water Supply Currently Affected. PSA Humana Planning Area Parent DMIS 0038 0038 Child DMIS 260 AD 0261 0262 AD 0513 AD 6306 AD 0038 0316 1230 Eligible Beneficiaries Enrolled Beneficiaries MTFs/UNITS 0038 0038 0038 0038 0038 0038 0038 0047 81,598 46,400 NBHC NAS Pensacola, FL NBHC Milton Whiting Field, FL NBHC NATTC Pensacola, FL NBHC NTTC Pensacola, FL OP Forces Pensacola, FL NH Pensacola, FL NBHC Gulfport, MS Camp Shelby, MS 81st Medical Group, Keesler AFB, Biloxi MS USCG, Mobile Clinic, MS USCG, Galveston Clinic, TX 96th Medical Group, Eglin AFB, FL 16th Medical Group, Hurlburt Field FL NACC New Orleans, LA BMC NAVSUPPACT East Bank, NOLA NBHC NAS Belle Chasse, NOLA USCG, New Orleans Clinic, LA 42nd Medical Group, Maxwell AFB AL NBHC Panama City, FL 325 Tyndall AFB FL. Lyster AHC Ft. Rucker AL 2nd Medical Group, Barksdale AFB LA NH Corpus Christi, TX NBHC Kingsville, TX 0073 0073 0073 0155 0073 0416 AD 7082 AD 0042 7139 0287 AD 1990 AD 78,108 46,839 0196 0042 0196 0042 0155 0042 7139 0038 0038 75,531 72,308 39,279 49,469 LA01 LA01 0038 0155 0436 0423 AD 0004 0265 0043 0003 0062 0118 0369 0370 AD 6316 AD 0317 0064 N/A N/A 0074 N/A N/A N/A N/A 43,783 20,521 0004 0043 0003 0062 0004 0043 0003 0062 0004 0038 0043 0003 0062 0118 0118 40,563 39,098 35,416 32,470 19,724 21,507 19,222 18,127 0118 0118 0118 0118 30,654 20,468 0317 0317 0064 0038 0064 N/A N/A 0074 N/A N/A N/A N/A 27,660 27,002 7,792 10,309 14,733 3,615 7,474 6,703 3,937 9,849 21,718 2,892 3,609 7,426 940 2,060 1,585 1,177 0064 0063 LA02 0074 0074 MS02 0013 0062 0109 AR02 LA03 TX06 NBHC Ingleside, TX OP Forces NH Corpus Christi, TX NBHC Meridian (Jackson MS) Bayne- Jones A CH FT. Polk LA TRICARE PRIME REMOTE TRICARE PRIME REMOTE 14th Medical Group, Columbus AFB, MS TRICARE PRIME REMOTE TRICARE PRIME REMOTE TRICARE PRIME REMOTE TRICARE PRIME REMOTE Total Number of Beneficia ries 638,754 352,812